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Appendix 5: Drug-Induced Pulmonary Disease

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    AMA Citation
    Drug-Induced Pulmonary Disease. In: Wells BG, DiPiro JT, Schwinghammer TL, DiPiro CV. Wells B.G., DiPiro J.T., Schwinghammer T.L., DiPiro C.V. Eds. Barbara G. Wells, et al.eds. Pharmacotherapy Quick Guide New York, NY: McGraw-Hill; . http://accesspharmacy.mhmedical.com/content.aspx?bookid=2177&sectionid=165471259. Accessed April 18, 2019.
    MLA Citation
    . "Drug-Induced Pulmonary Disease." Pharmacotherapy Quick Guide Wells BG, DiPiro JT, Schwinghammer TL, DiPiro CV. Wells B.G., DiPiro J.T., Schwinghammer T.L., DiPiro C.V. Eds. Barbara G. Wells, et al. New York, NY: McGraw-Hill, , http://accesspharmacy.mhmedical.com/content.aspx?bookid=2177&sectionid=165471259.

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TABLE A5–1: Drugs That Induce Apnea
Relative Frequency of Reactions
Central nervous system depression
Narcotic analgesics F
Barbiturates F
Benzodiazepines F
Other sedatives and hypnotics I
Tricyclic antidepressants R
Phenothiazines R
Ketamine R
Promazine R
Anesthetics R
Antihistamines R
Alcohol R
Fenfluramine I
L-Dopa R
Oxygen R
Respiratory muscle dysfunction
Aminoglycoside antibiotics I
Polymyxin antibiotics I
Neuromuscular blockers I
Quinine R
Digitalis R
Myopathy
Corticosteroids F
Diuretics I
Aminocaproic acid R
Clofibrate R

(F, frequent; I, infrequent; R, rare.)

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TABLE A5–2: Drugs That Induce Bronchospasm
Relative Frequency of Reactions
Anaphylaxis (IgE-mediated)
Penicillins F
Sulfonamides F
Serum F
Cephalosporins F
Bromelin R
Cimetidine R
Papain F
Pancreatic extract I
Psyllium I
Subtilase I
Tetracyclines I
Allergen extracts I
LI-Asparaginase F
Pyrazolone analgesics
Direct airway irritation
Acetate R
Bisulfite F
Cromolyn R
Smoke F
N-acetylcysteine F
Inhaled steroids I
Precipitating IgG antibodies
β-Methyldopa R
Carbamazepine R
Spiramycin R
Cyclooxygenase inhibition
Aspirin/NSAIDs F
Phenylbutazone I
Acetaminophen R
Anaphylactoid mast-cell degranulation
Narcotic analgesics I
Ethylenediamine R
Iodinated-radiocontrast media F
Platinum R
Local anesthetics I
Steroidal anesthetics I
Iron–dextran complex I
Pancuronium bromide R
Benzalkonium chloride I
Pharmacologic effects
α-Adrenergic receptor blockers I-F
Cholinergic stimulants I
Anticholinesterases R
β-Adrenergic agonists R
Ethylenediamine tetraacetic acid R
Unknown mechanisms
ACE inhibitors I
Anticholinergics R
Hydrocortisone R
Isoproterenol R
Monosodium glutamate I
Piperazine R
Tartrazine R
Sulfinpyrazone R
Zinostatin R
Losartan R

(ACE, angiotensin-converting enzyme; F, frequent; I, infrequent; Ig, immunoglobulin; NSAIDs, nonsteroidal anti-inflammatory drugs; R, rare.)

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TABLE A5–3: Tolerance of Anti-inflammatory and Analgesic Drugs in Aspirin-Induced Asthma
Cross-Reactive Drugs Drugs with No Cross-Reactivity
Diclofenac Acetaminophena
Diflunisal Benzydamine
Fenoprofen Chloroquine
Flufenamic acid Choline salicylate
Flurbiprofen Corticosteroids
Hydrocortisone hemisuccinate Dextropropoxyphene
Ibuprofen Phenacetina
Indomethacin Salicylamide
Ketoprofen Sodium salicylate
Mefenamic acid
Naproxen
Noramidopyrine
Oxyphenbutazone
Phenylbutazone
Piroxicam
Sulindac
Sulfinpyrazone
Tartrazine
Tolmetin
a

A very small percentage (5%) of aspirin-sensitive patients react to acetaminophen and phenacetin.

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TABLE A5–4: Drugs That Induce Pulmonary Edema
Relative Frequency of Reactions
Cardiogenic pulmonary edema
Excessive intravenous fluids F
Blood and plasma transfusions F
Corticosteroids F
Phenylbutazone R
Sodium diatrizoate R
Hypertonic intrathecal saline R
β2-Adrenergic agonists I
Noncardiogenic pulmonary edema
Heroin F
Methadone I
Morphine I
Oxygen I
Propoxyphene R
Ethchlorvynol R
Chlordiazepoxide R
Salicylate R
Hydrochlorothiazide R
Triamterene + hydrochlorothiazide R
Leukoagglutinin reactions R
Iron–dextran complex R
Methotrexate R
Cytosine arabinoside R
Nitrofurantoin R
Dextran 40 R
Fluorescein R
Amitriptyline R
Colchicine R
Nitrogen mustard R
Epinephrine R
Metaraminol R
Bleomycin R
Iodide R
Cyclophosphamide R
VM-26 R

(F, frequent; I, infrequent; R, rare.)

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TABLE A5–5: Drugs That Induce Pulmonary Infiltrates with Eosinophilia (Loeffler’s Syndrome)
Drug Relative Frequency of ...

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